Removal tool for use with endoscopic device

ABSTRACT

A system for use with an endoscopic device. The system can include a shaft having a proximal end, a distal end, and at least one output port, wherein a portion of the shaft is surrounded by a single polyurethane expandable material, wherein the polyurethane expandable material is expandable from a diameter of at least approximately 5.0 mm to a diameter of approximately 25 mm. The system can also include a manifold connected to the proximal end of the shaft, the manifold including one or more fluid coupling ports for receiving an injected fluid, wherein at least one of the one or more fluid coupling ports is in fluid communication with the at least one output port and wherein when received, the system is configured to convey the injected fluid from the manifold to the shaft resulting, at least in part, in expanding the polyurethane expandable material.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. Non-Provisional patentapplication Ser. No. 15/087,754, filed on Mar. 31, 2016 and entitled“REMOVAL TOOL FOR USE WITH ENDOSCOPIC DEVICE” which is a continuation ofU.S. Non-Provisional patent application Ser. No. 13/843,891 filed Mar.15, 2013 and entitled “REMOVAL TOOL FOR USE WITH ENDOSCOPIC DEVICE,” theentireties of which are incorporated herein by reference.

BACKGROUND 1. Field of the Invention

This disclosure relates to devices that may be used, for example, inassociation with endoscopic surgery.

2. Description of Related Art

At times, there may be a need to remove an object from one or more of anindividual's body orifices, including orifices within the alimentarycanal. To remove an object from an orifice within an individual'salimentary canal, such as a stone or other object lodged in a bile duct,endoscopic surgery may be performed. Endoscopic surgery may entail, forexample, use of an endoscopic device that may be equipped with a camerathat is entered into an individual's mouth and advanced through thealimentary canal until appropriately positioned within the individual'sduodenum so that a stone or other object may be removed. However,endoscopic surgery may represent a time-consuming process in which anendoscope, and object removal tools, may be positioned into place by wayof a working channel of an endoscope. Once in position, for example,removal of the stone or other object may involve a high degree ofcooperation between the endoscope and the removal tools, for example. Onoccasion, cooperation among an endoscope and removal tools may be inneed of improvement to bring about decreases in endoscopic surgerycosts, decreases in surgeon and support staff time, as well as reducinga level of discomfort of the patient undergoing endoscopic surgery.

BRIEF DESCRIPTION OF DRAWINGS

Claimed subject matter is particularly pointed out and distinctlyclaimed in the concluding portion of the specification. However, both asto organization and/or method of operation, together with objects,features, and/or advantages thereof, claimed subject matter may best beunderstood by reference to the following detailed description if readwith the accompanying drawings in which:

FIG. 1 is a diagram of an embodiment showing use of an endoscope andremoval tool deployed in an alimentary canal;

FIGS. 2A and 2B are diagrams of embodiments of a removal tool;

FIG. 3 is a diagram showing deployment of an embodiment of a removaltool;

FIG. 4 is a diagram showing a portion of an embodiment of a removaltool; and

FIG. 5 is a flow diagram of a process for using an embodiment of aremoval tool.

Reference is made in the following detailed description to accompanyingdrawings, which form a part hereof, wherein like numerals may designatelike parts throughout to indicate corresponding and/or analogouscomponents. It will be appreciated that components illustrated in thefigures have not necessarily been drawn to scale, such as for simplicityand/or clarity of illustration. For example, dimensions of somecomponents may be exaggerated relative to other components. Further, itis to be understood that other embodiments may be utilized. Furthermore,structural and/or other changes may be made without departing fromclaimed subject matter. It should also be noted that directions and/orreferences, for example, up, down, top, bottom, and so on, may be usedto facilitate discussion of drawings and/or are not intended to restrictapplication of claimed subject matter. Therefore, the following detaileddescription is not to be taken to limit claimed subject matter and/orequivalents.

DETAILED DESCRIPTION

Reference throughout this specification to “one example,” “one feature,”“one embodiment,” “an example,” “a feature,” “an implementation,” or “anembodiment” means that a particular feature, structure, orcharacteristic described in connection with the feature, example, orembodiment is included in at least one feature, example, or embodimentof claimed subject matter. Thus, appearances of the phrase “in oneexample,” “an example,” “in one implementation,” “an implementation,”“an embodiment,” or “in one embodiment” in various places throughoutthis specification are not necessarily all referring to the samefeature, example, or embodiment. Particular features, structures, orcharacteristics may be combined in one or more examples, features, orembodiments. The term “patient” and “individual” may be usedinterchangeably herein. The terms “duct,” “ostium,” “opening,” and“orifice,” as used herein, may comprise an opening into a vessel and/orcavity of the body. It should be noted that although significantportions of the description of embodiments may be directed towardremoval of a stone or other object lodged within a bile duct,embodiments are not limited to such uses, and claimed subject matter isintended to embrace various applications such as those involving otherportions of the alimentary canal, other orifices and structures of ahuman patient, orifices and structures of an animal patient, orintricate mechanical assemblies and/or structures.

A removal tool may be used with an endoscope to assist in removing anobject, such as a stone lodged in one or more of bile ducts, forexample, of an individual. A stone or other object may be dislodged froma bile duct by, for example, urging the object toward an ostium or otheropening which permits the object to pass through the opening and intothe duodenum, for example. Responsive to entry into the duodenum, theobject may be may be disposed of via normal discharge of solid wastefrom the body. Subsequent to entry of the object into the duodenum, theremoval tool may be stowed within an endoscopic device and theendoscopic device may be withdrawn from the body through the alimentarycanal, for example.

A removal tool, which may comprise an expandable vessel, such as aballoon, may be formed from a thermoplastic polyurethane material. Aremoval tool may be conveyed through a working channel of an endoscopicdevice after the endoscopic device is positioned within a body cavity. Acamera located proximate with a distal end portion of an endoscopicdevice may be employed to provide imagery to a surgeon, for example, toinform the surgeon that a portion of an endoscopic device may be inposition to deploy a removal tool. A guide wire may be extended from theendoscopic device and advanced through an ostium, such as thehepatopancreatic ampulla. A shaft coupled to the guide wire may followthe inserted guide wire through an ostium, for example, and advanced toa location nearby a stone or other object to be removed. Contrast dye,which may be visible through a radioimaging device (i.e., x-ray machine,computer aided tomographic scanner, or the like) may be dispensedthrough a manifold coupled to a shaft and released under pressure to anexpandable vessel and may assist a surgeon in detecting an approximatelocation of an object to be removed. At an appropriate time, volume ofan expandable vessel may be increased through the use of a compressibleand/or incompressible fluid dispensed from a shaft until the expandablevessel occupies a threshold volume. The shaft and expandable vessel maythen be urged toward an ostium, in a manner that pushes the stone orother object through the ostium.

In embodiments, a thermoplastic urethane expandable vessel may be fusedto a polyurethane shaft, for example, by way of a thermoplastic weldingprocess. In embodiments, a thermoplastic welding process may give riseto fusing an expandable vessel to a cylinder-shaped polyurethane shaftat one or more locations along a periphery of the shaft. Accordingly, anexpandable vessel may be unlikely to separate from a polyurethane shaftthereby enhancing ease of removal of a stone or other object from anorifice. A polyurethane shaft may comprise one or more output ports fordispensing contrast dye, which may permit a surgeon to observe areasproximate with an object to be removed, as well as observing nearbystructures, such as, for example, a biliary tree that may be distal froman object to be removed. A thermoplastic urethane expandable vessel mayfurther include a radiopaque marking, such as a radiopaque medical ink.

In an embodiment, a pair of radiopaque markings may be spaced aparticular distance from one another if an expandable vessel isdeflated, for example. If an expandable vessel becomes inflated, adistance between radiopaque markings may increase, thereby allowing asurgeon to assess an extent to which a vessel has been inflated. Inembodiments, an expandable vessel may be exposed to an electron beam,which may sanitize a thermoplastic polyurethane expandable vessel, forexample, and/or may serve to cross-link polymers in a manner thatincreases strength of thermoplastic polyurethane. In embodiments, anexpandable vessel may be inflated using, for example, saline solution.In expandable vessel may be configured, for example, to be nonreactivewith a saline solution.

Embodiments may represent a significant performance increase overconventional latex-based expandable vessels. Latex-based vessels, forexample, may be prone to breakage, leakage, and/or separation from ashaft to which a latex-based vessel may be attached. In particularconventional implementations, latex-based vessels may be affixed to ashaft using an adhesive. However, in many instances, such adhesive doesnot possess sufficient bonding strength to resist shear and/or otherstresses that may be encountered during inflation, and/or removal ofobjects from body orifices, for example. In response to breakage,leakage, and/or separation, a shaft and latex vessel may be removed froma patient so that another attempt at stone or other object removal maybe performed. Often, removal of a shaft may involve drawing of the shaftproximately through a working channel of an endoscopic device so that anew shaft and expandable vessel can be reinserted and advanced into apatient's alimentary canal. The shaft and latex-based expandable vesselmay be repositioned in an individual's alimentary canal and the objectremoval process may be reattempted. In many instances, this may giverise to an undesirable increase in surgeon and support staff time, anincrease in equipment costs, and an increase patient discomfort.

Use of expandable vessels comprising materials other than latex may alsobenefit healthcare workers, such as surgeons and support staff, involvedin endoscopic procedures. For example, if an endoscopic surgeon or otherindividual involved in endoscopic procedures suffers from an allergy tolatex, the individual may employ material handling practices to reduceexposure. Further, patients who suffer from latex allergies may alsoexperience inflammation and/or additional undesirable consequences inresponse to exposure to latex-based expandable vessels. Accordingly, useof thermoplastic polyurethanes, for example, may represent a means ofavoiding such exposure, which may reduce undesirable consequencesassociated with exposure to latex-based expandable vessels, for example.

According to one illustrative embodiment, as disclosed herein, athermoplastic polyethylene expandable vessel may be welded to acylinder-shaped polyurethane shaft. An expandable vessel may encircle apolyurethane shaft and may be thermoplastically welded or otherwisefused to the shaft, for example. Saline solution, delivered to anexpandable vessel at a suitable pressure, may inflate a vessel to adiameter of, for example, between approximately 5.0 mm and approximately25.0 mm. It has been observed that a thermoplastic polyethyleneexpandable vessel of approximately 5.0 mm to approximately 25.0 mm maybe of sufficient girth to form a temporary seal such that, when drawntowards the ostium, for example, stones or other objects may be urgedalong the biliary duct, for example, and through a patient's ampulla ofvater (i.e., the hepatopancreatic ampulla) and into the patient'sduodenum. Due at least in part to increased strength of expandablevessel, such object removal may be performed in a single attempt.

FIG. 1 is a diagram of an embodiment 10 showing use of an endoscope andremoval tool deployed in an alimentary canal. In accordance with aconventional endoscopic procedure, endoscopic device 100, for example,may be advanced through a patient's alimentary canal while a patient is,for example, under sedation. Endoscopic device 100 may be advanced intoa patient's mouth, into the patient's esophagus, through the cardia,stomach, and pyloric valve, for example, and into a patient's duodenum.It should be noted that embodiment 10 represents merely a singleimplementation of a removal tool for use with an endoscopic procedure,and claimed subject matter is not limited to any particular embodiment,such as that of FIG. 1. For example, a removal tool may be used inassociation with endoscopic devices and advanced into other bodycavities, including body cavities of a human patient, animal patient, orinto an intricate mechanical structure, for example. Further,implementations may involve the use of other types of probing devicesthat may be used to view internal structures of living organisms and/ormechanical apparatuses, and claimed subject matter is not limited inthis respect.

Endoscopic device 100 may include camera 103 which, for example, mayprovide visual feedback to assist an endoscopic surgeon in positioningan endoscopic device. Although not shown in FIG. 1, endoscopic device100 may additionally comprise a lamp or other illumination source so asto enable lighting of body cavities, such as alimentary canal 135.Further, although not shown explicitly in FIG. 1, endoscopic device 100may include a working channel that may permit tools, utensils, and otherimplements to be conveyed into, for example, a patient's alimentarycanal and/or other body orifice. In the example of FIG. 1, endoscopicdevice 100 may be used to convey shaft 140 to a location proximate with,for example, ostium 120. In an embodiment, ostium 120 represents anopening, such as the hepatopancreatic ampulla, through which guide wire150 may be advanced.

If endoscopic device 100 is positioned proximate with ostium 120, asurgeon may advance guide wire 150 through ostium 120. Subsequent topenetration of ostium 120, shaft 140 may also be advanced through ostium120. In an embodiment, advancement of guide wire 150 and/or shaft 140may be enabled, at least in part, using camera 103 to obtain visualfeedback of structures within, for example, alimentary canal 135.

Upon entry to biliary duct 105, by way of ostium 120, for example, shaft140 may be at least partially advanced toward stone 125 and further(i.e., distally) into biliary duct 105. In embodiments, for example, oneor more of distal shaft port 110 and proximal shaft 115 may be used todispense contrast dye, which may be used in conjunction with afluoroscopic device, such as an x-ray machine, to provide imagery to anendoscopic surgeon. In one exemplary embodiment, an endoscopic surgeonmay locate ostium 120 by way of camera 103, and for example, uponobserving the entry of guide wire 150 and at least a distal portion ofshaft 140 into ostium 120, dispense of contrast dye through, forexample, distal shaft port 110. Contrast dye, which may distributewithin biliary duct 105, may enable a surgeon to position shaft 140relative to stone a 125. It should be noted, however, that someembodiments may position a shaft without assistance from a contrast dye,and claimed subject matter is not limited in this regard.

If positioned within biliary duct 105, such as, for example, shown inFIG. 1, shaft 140 may introduce saline solution into expandable vessel130. Shaft 140 may be configured to be nonreactive with saline or othersolution introduced into expandable vessel 130. Under an appropriatefluid pressure, expandable vessel 130 may expand in size until, forexample, vessel 130 comes into contact with an inner surface of biliaryduct 105. Consequently, at least in some embodiments, expandable vessel130 may form a temporary seal that may preclude contrast dye emanatingfrom distal shaft port 110 to seep or leak towards ostium 120. Thus,contrast fluid may be permitted to fill biliary duct 105. Filling ofbiliary 105 with contrast dye may, for example, enable an endoscopicsurgeon, radiologist, or other healthcare professional, for example, toobserve more distal structures that may lie within and/or be in fluidcommunication with biliary duct 105. Thus, additional structures such asthe common bile duct, pancreatic duct, cystic duct, common hepatic duct,as well as other structures may be visible if expandable vessel ispermitted to form a temporary seal of at least a portion of biliary duct105. It should be noted, however, that liquids, such as contrast dye,emanating from distal shaft port 110 may provide other benefits, andclaimed subject matter is not limited in this respect.

As shown in FIG. 1, shaft 140 may additionally comprise proximal shaftport 115. In embodiments, proximal shaft port 115 may additionally beemployed to distribute contrast dye within biliary duct 105, forexample. Consequently, if permitted to at least partially surround stone125, contrast dye may enable an endoscopic surgeon, radiologist, and/orother professional to monitor movement of stone 125, as expandablevessel 130 is retracted toward ostium 120. In some instances, it may bepossible, for example, to observe the passing of stone 125 throughostium 120, and into alimentary canal 135. Again, however, use ofcontrast dye dispensed by way of distal shaft port 110 and/or proximalshaft port 115 represents one or more particular embodiments, andclaimed subject matter is not limited in this respect. After stone 125has emptied into alimentary canal 135, for example, expandable vessel130 may be decreased in size, for example, by way of drawing salinesolution from the expandable vessel, and retracting shaft 140 to alocation within endoscopic device 100. Stowage of shaft 140 withinendoscopic device 100 may permit an endoscopic surgeon, for example, toremove the shaft and expandable vessel device from a patient.

FIG. 2A is a diagram of an embodiment of a removal tool 15. Removal tool15 may comprise, for example, polycarbonate manifold 260, polyolefinstrain relief sheath 265, polyurethane shaft 270, and polyurethaneexpandable vessel 275. In embodiments, polyolefin strain relief sheath265 may surround a portion of shaft 270 in a manner that prevents, or atleast reduces likelihood of improperly bending or kinking shaft 270 asshaft 270 and expandable vessel 275 are passed through a working channelof an endoscopic device, such as endoscopic device 100. In embodiments,shaft 270 comprises a material that is nonreactive with radioimagingcontrast dyes, saline solution, and/or other compressible orincompressible fluids that may be transported through manifold 260 andshaft 274 dispensing at a distal end portion of shaft 270, such as alocation nearby expandable vessel 275, for example.

Manifold 260 may comprise a polycarbonate material and one or more fluidcoupling ports such as fluid coupling ports 261, 262, and 263, forexample. In an embodiment, fluid coupling port 261 may be used to injectradioimaging contrast dye to a distal portion of shaft 270, such as, forexample, distal output port 271. Likewise, fluid coupling port 262 maybe used to inject saline solution or other fluid, under suitablepressure, to inflate expandable vessel 275 through medial output port272 (which may be obscured from view by expandable vessel 275).Likewise, fluid coupling port 263 may be used to inject radioimagingcontrast dye to a proximal output port, such as, for example, proximaloutput port 273.

FIG. 2B is a diagram of an embodiment of a removal tool 20. The removaltool of FIG. 2B may be suitable, for example, for insertion into aworking channel of an endoscopic device, such as endoscopic device 100of FIG. 1. However, embodiment 20 may be suitable for insertion intoother devices, and claimed subject matter is not limited in thisrespect. In embodiments, insertion into a working channel begins, forexample, with insertion of distal end portion 220. If situated within anendoscopic device, removal tool 20 may be deployed, perhaps with theassistance of a camera, such as camera 103 of FIG. 1, to a locationproximate with an ostium or other opening into a body cavity. Beginningwith guide wire 250, shaft 240 may be inserted into an ostium.

If distal end portion 220 is positioned proximate with a stone or otherobject designated for removal, for example, medial shaft port 117 maydispense fluid, such as saline solution, which may increase volume ofexpandable vessel 230. Control for dispensing of saline solution may,for example, be provided by one or more of injector controls 235. Asdiscussed with reference to FIG. 1, an expandable vessel may expand toform a temporary seal within a biliary duct or other structure. If atleast a partial temporary seal can be formed, by way of expansion ofexpandable vessel 230 coming into contact an inner surface of a biliaryduct, for example, contrast dye may be dispensed from one or more ofdistal shaft port 210 and proximal shaft port 215. Dispensing ofcontrast dye from distal shaft port 210 may, for example, enable anendoscopic surgeon, radiologist, or other healthcare professional toobserve imagery corresponding to additional structures positioneddistally from shaft 240, for example. Dispensing of contrast dye mayalso permit real-time observation, by way of a fluoroscope (i.e., x-raymachine) of withdrawal of shaft 240 as well as urging of a stone orother object toward a patient's alimentary canal using expandable vessel230, for example.

FIG. 3 is a diagram showing deployment of an embodiment of a removaltool 30. In FIG. 3, shaft 340 may be advanced by guiding the shaft tofollow a guide wire (not shown in FIG. 3) coupled to sealed distal end322. Shaft 340 may be inserted into a working channel of an endoscopicdevice, such as endoscopic device 100 of FIG. 1, and inserted into apatient's alimentary canal, for example. After entry into a bodyorifice, such as an ostium (e.g., the hepatopancreatic ampulla),contrast dye 350 may be dispensed from one or more of distal shaft port310 and proximal shaft port 315. Contrast dye may, at least in someembodiments, be employed to enable an endoscopic surgeon operating afluoroscope to appropriately position shaft 340 proximate with a stoneor other object for removal. However, removal tool 30 of FIG. 3 may beuseful in a variety of other scenarios, such as object removal at otherlocations of a patient, and may make possible object removal from otherliving organisms and/or mechanical structures. Claimed subject matter isintended to embrace all such uses of removal tool 30.

At an appropriate time, saline solution may be dispensed into expandablevessel 330 way of medial shaft port 317. If dispensed at a suitablepressure, expandable vessel 330 may gain in volume until expandablevessel occupies at least a considerable cross-section of a body orifice.In FIG. 3, radiopaque markings 334, which may comprise an x-rayabsorbing material, such as barium sulfate, may be observed to separatefrom one another as expandable vessel 330 increases in volume, forexample. In other embodiments, radiopaque markings may comprise a singlemark that increases in surface area as expandable vessel 330 increasesin volume. In other embodiments, additional radiopaque markings may beused and may be disposed at various locations on a surface of, forexample, expandable vessel 330 without limitation, and claimed subjectmatter is intended to embrace all such uses of radiopaque markingsapplied to expandable vessels. Expandable vessel 330 may be fused by wayof thermoplastic welding to shaft 340 at, for example, fused portions331 and 332. In embodiments, use of thermoplastic polyurethaneexpandable vessels fused to polyurethane shafts, for example, may removea need for adhesive used for affixing expandable vessels of othercompositions to shafts, such as shaft 340. In addition, use ofthermoplastic polyurethane expandable vessels fused to polyurethaneshafts may result, at least in part, in a much stronger bond than wouldresult if latex expandable vessels were to be affixed, via an adhesive,to polyurethane shafts.

FIG. 4 is a diagram showing a portion 40 of an embodiment of a removaltool. In FIG. 4, expandable vessel 430 may comprise a thermoplasticpolyurethane elastomer that may be partially or fully thermoplastic. Inembodiments, expandable vessel 430 may comprise a linear segment blockcopolymer comprising “hard” and “soft” segments. A hard segment maycomprise an aromatic or aliphatic material. Aromatic thermoplasticpolyurethanes may be based on isocyanates such as methylene diphenyldiisocyanate and/or related compounds. Aliphatic thermoplasticpolyurethanes may be based on isocyanates such as methylene dicyclohexyldiisocyanate (H12MDI). Isocyanates may be combined with short-chaindiols to form a “hard” segment. It should be noted that these are merelyexamples of engineered thermoplastic polyurethanes that may be used toform expandable vessel 430, however claimed subject matter is notlimited in this regard.

In FIG. 4, cross-linked region 441 may indicate a portion of expandablevessel 430 that comprises additional cross-linked polymers by way ofexposure to an electron beam. In embodiments, exposure to an electronbeam may give rise to cross-linking of adjacent or nearby polymer chainswith one another, for example. Such electron beam exposure of a portionof expandable vessel 430 may further increase strength properties of athermoplastic polyurethane material used to form expandable vessel 430.Expandable vessel 430 may be fused to shaft 440 by way of, for example,thermoplastic welding.

FIG. 5 is a flow diagram of a process for using an embodiment 50 of aremoval tool. The arrangement of components in FIG. 1 may be suitablefor performing the method of embodiment 50. However, claimed subjectmatter is not limited to the particular implementation of any particularfigure shown and described herein and alternate arrangements ofcomponents in other implementations may be used. Example embodiments,such as embodiment 50 shown in FIG. 5 may include blocks in addition tothose shown and described, fewer blocks, blocks occurring in an orderdifferent than may be identified, or any combination thereof.

At 510, an expandable vessel fused to a shaft may be inserted through aworking channel of an endoscopic device. An expandable vessel maycomprise a thermoplastic polyurethane material fused to a polyurethaneshaft, for example, and claimed subject matter is not limited in thisrespect. Additionally, although expandable vessel may be insertedthrough an endoscopic device, expandable vessels may be inserted usingother instruments, such as sigmoidoscopy devices, colonoscopy devices,or other imaging instruments, and claimed subject matter is not limitedin this respect.

At 520, a guide wire may be extended from an endoscopic device andinserted through an ostium. A camera or other imaging device may be usedby an endoscopic surgeon, for example, to position an endoscopic deviceadjacent an ostium or other structure. At 530, a shaft may be advancedthrough an ostium, wherein a shaft may be fused to a thermoplasticpolyurethane expandable vessel, for example. 530 may also comprisedispensing a fluoroscopic contrast dye from one or more ports of a shaftso as to assist in radio imaging, for example, of an area adjacent anobject lodged, such as an area immediately distal of hepatopancreaticampulla within a patient's alimentary canal.

At 540, a fluid may be injected through a shaft to inflate an expandablevessel. For example, a saline solution may be employed to inflate orexpand an expandable vessel, however, claimed subject matter is notlimited to use of saline solution. In other embodiments, a variety ofalternate, chemically inert compositions may be employed. At 550, if anexpandable vessel reaches an appropriate size, a contrast fluid may beinjected into areas proximal and/or distal to the expandable vessel. At550, an expandable vessel of an appropriate size may assist in forming atemporary seal which may allow additional contrast dye to be ejectedinto a body orifice. In embodiments, this may allow imaging ofadditional portions of a patient's biliary tree, such as, for example,the common bile duct, the pancreatic duct, the cystic duct, the commonhepatic duct, etc.

At 560, an expandable vessel and an object may be drawn (i.e. pulled)through an ostium, for example. 560 may comprise, for example, radioimaging of an area at least partially surrounding a stone or otherobject to be removed as the object is urged, by way of contact with anexpandable vessel, towards an ostium, for example. The method mayconclude with the deposit of an object to be removed into the alimentarycanal where natural solid waste removal processes may take place.

While there has been illustrated and/or described what are presentlyconsidered to be example features, it will be understood by thoseskilled in the relevant art that various other modifications may be madeand/or equivalents may be substituted, without departing from claimedsubject matter. Additionally, many modifications may be made to adapt aparticular situation to teachings of claimed subject matter withoutdeparting from one or more central concept(s) described herein.Therefore, it is intended that claimed subject matter not be limited toparticular examples disclosed, but that claimed subject matter may alsoinclude all aspects falling within appended claims and/or equivalentsthereof.

What is claimed is:
 1. A system for use with an endoscopic device,comprising: a shaft having a proximal end, a distal end, and at leastone output port, wherein a portion of the shaft is surrounded by asingle polyurethane expandable material, wherein the polyurethaneexpandable material is expandable from a diameter of at leastapproximately 5.0 mm to a diameter of approximately 25 mm; and amanifold connected to the proximal end of the shaft, the manifoldcomprising one or more fluid coupling ports for receiving an injectedfluid, wherein at least one of the one or more fluid coupling ports isin fluid communication with the at least one output port and whereinwhen received, the system is configured to convey the injected fluidfrom the manifold to the shaft resulting, at least in part, in expandingthe polyurethane expandable material.
 2. The system of claim 1, whereineach of the one or more fluid coupling ports is in fluid communicationwith only one of the at least one output port.
 3. The system of claim 1,wherein the shaft comprises a plurality of output ports comprising adistal output port, medial output port, and proximal output port.
 4. Thesystem of claim 3, wherein the polyurethane expandable material ispositioned over the medial output port.
 5. The system of claim 3,wherein the shaft is configured to convey fluoroscopic contrast dye tothe distal output port.
 6. The system of claim 3, wherein the shaft isconfigured to convey fluoroscopic contrast dye to the proximal outputport.
 7. The system of claim 1, wherein the injected fluid comprises asaline solution.
 8. The system of claim 1, wherein the shaft comprises apolyurethane material, and wherein a portion of the polyurethaneexpandable material is fused to the polyurethane material of said shaft.9. The system of claim 1, wherein the shaft comprises a polyolefinstrain relief sheath.
 10. The system of claim 1, wherein at least aportion of the polyurethane expandable material comprises a cross-linkedmaterial.